Organ Donation and Racial Disparity: Analytical Essay

To live day by day is a blessing in itself. To go by worry free about your health is a luxury many take for granted, including myself. I never think about whether my lungs are okay, can my bones take another backpacking trip; will my heart give out on me if I try to run another mile. For me these are things I push to the back of my mind, and am extremely grateful for, but for others, those thoughts of health and life or death are everyday occurrences. Thinking about specific organ usage for most is not a thought, but for people with serious health conditions it is something that must be taken care of daily. That is where organ donation can come into play. Organ donation “refers to donating human cells, tissues, or organs intended for human applications. The donor is a human being, living or deceased, who is a source of cells, tissues, or organs for the purpose of transplantation” (Sachdeva, pg. 20). Which by all means is a miracle, but science has been able to pursue and execute donations and transplants for years, but with those years comes issues, and that includes the issue of racial disparity.

History of organ transplants can date back all the way to 1760 when the term transplant was brought about by John Hunter. This then progressed through the 1900s with transplants of corneas, rentals, and the first successful renal transplant in 1954, performed by Joseph Murray and John Merrill (Sachdeva, pg. 19). From there much success and failure occurred to continue the medical field. But with transplants there must be a donor from which the tissues, organs, and cells comes from. To become a donor in today’s day and age is much easier than it had been in the past. This process can vary state to state but for the most part the procedure to become a donor is to register online through you states organ donation website. When you get a driver’s license for example there is an option for individuals to say whether or not they want to become a donor and that will be put on the license itself (Valerie, 2021). For organ donation after death specifically is it helpful to “Include Organ Donation in Your Health Care Power of Attorney” (Valerie, 2021). This can aid so that after death things are clear for what you would like to do with your choice of being an organ donor. But donations of organs and such does not always wait till someone is deceased to use; people who are living and registered are able to help out people with organs and tissues that are available to transplant without the death of a donor through surgical procedure.

Organ donations are crucial in the world. As of today, “More than 100,000 men, women and children are waiting for lifesaving organ transplants” (Organ Donation, 2021). This number is huge and continuing to grow, and the importance of becoming a donor should be growing as well. From the website Donating Life America it has found that every ten minutes “another person is added to the national transplant waiting list” (Organ Donation, 2021). Which to some can be completely shocking, but it is a statistic that should used as encouragement to register to become a donor. And becoming a donor is not limited to age or race, anyone can register, and it is encouraged that people do. 64.9% of people who sign a donor registration card are white (Siminoff, pg. 995). Although this is great, this is where racial disparity plays a role in the organ donation world.

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Now, organ donation is not based off of race, it is through blood types, genetic matchings and other tests and factors that matches donors with recipients. But “Patients from communities of color make up more than half – 60% – of the national waiting list for a life-saving transplant” (Race, 2020). This number is important because although matching is not based off of races, “individuals waiting for an organ transplant will have a better chance of receiving one if there are large numbers of donors from their racial/ethnic background” (Race, 2020). Racial disparity has become a topic of todays news and history. From racism, to movements, to a pandemic more information of racism and disparities has come to light. Specifically in this class, about race and ethics in healthcare many topics have been learned about and researched that has showed racial disparity is an issue in the world of healthcare. From lack of adequate information to locations and accessibility, healthcare is something that is constantly needing reform and work to better reach people who need medical help. The United Network of Organ Sharing has acknowledged, with recent global issue, that racial disparity is an issue in the organ donation and transplant world; but they are working to try to overcome such issues (Achieving, 2020). A part of the problem is people not knowing enough about organ donation and transplantation. In a study done by Raymond and Patricia Horton they found that “that there are gaps in the public’s knowledge regarding organ donation and transplantation” (Horton, pg. 797). This can be fixed by putting more information out there and trying to reach to more people through technology and personal interactions. And although that will help, it does not specifically address the racial disparity factor that is associated with organ donation. In a journal put out regarding racial disparity it found five factors that are considered limitations by forty African Americans, these include “lack of transplantation awareness, religious beliefs and misperceptions, distrust of the medical community, fear of premature declaration of death after signing a donor card, and fear of racism” (Bratton, 2011). These factors are huge, and truthfully understandable. Racism and lack of trust in the healthcare community has been around for ages, and it is no stranger to the organ donation side of things. For many who are unable to be well informed by healthcare providers it can lead to mistrust and an unwillingness to want to register or sign up for organ donation, or even insurance and other such medical services. Statistics from the Gift of Life Donor Program put out that on the national transplant list “29% of people waiting for life-saving organ transplants in the nation are African American” (Race, 2020). They also found that in the among Asian and Hispanic people that “Nearly 10,000 of those on the national waiting list are Asian/Pacific Islander” and “23,000 of those on the national waiting list are Hispanic/Latino” (Race, 2020). That is in total over 24,000 individuals of the 100,000 people on the waiting list. That is a huge number but unfortunately that number is not as big when it come to the amount of people registered to be organ donors of those races just listed. And to some this raises the question of why are there not as many donors of other ethnicities as there are of white people that are registered? One answer to this was found in an article put out by Journal of General Internal Medicine stating, “Regarding trust, other studies have found that African Americans are more likely to believe that health care professionals will not do as much to save their lives if they are designated organ donors and characterize the organ distribution system as unfair” (Siminoff, pg. 999). Which can also be backed by common knowledge of racism and how it can and is found in healthcare. White people have a lot of privilege when it comes to health care in my opinion. They have access to knowledge and are more willing to ask questions to health care providers compared to other races. The ability to communicate, ask questions and receive the best care is something white privilege helps with tremendously, but other people cannot say the same. This lack of trust for others races specifically African American is one of the large reason why people do not register to donate (Siminoff, 2000).

In a digital age like today, society should be able to put out more information and reach more people but it does not always reach the people it needs to. Information and knowledge can impact trust in the healthcare community, which is why it is so important to make those factors more accessible. If more people can become informed it could help with individuals wanting to sign up to become donors. But lack on information is not the only reason, as stated before other races, specifically African Americans found that the system of organ distribution is not a fair field (Siminoff, pg. 999). Of people waiting specifically for a kidney transplant “21.4 percent of kidney transplant recipients are African-American (DHHS 1999). African-American patients who receive kidney transplants must wait, on average, 1,185 days compared to 605 days for white Americans (DHHS 1999)” (Siminoff, 2000). And to many that difference in number of days can be seen as a reason that the organ donation system is unfair. Although people can find this to be unfair, this barrier can lead to lack of African American donors as well as other races. A big thing found in overall research is that minorities races are not completely aware of the fact that they are needed as donors to expand the race gap of donors and recipients. Whether that is due to lack of information or desire to donate, if positives are not put out there about why people should register there is not much of a reason for people to.

That is why I would believe that if easier and accessible information and statistics were put out about how race, although not the defining factor for donation, can aid in finding matches more people would be inclined to act and register. Providing awareness would be a good form of action to try to help with racial disparity. Yes, people are aware, but the awareness can lead to a negative connotation, whereas if more information were put out about how helpful it can be to become a donor of a different race besides white it could impact many people lives who are on the transplant list. Just like how people are more inclined to buy a product that has positive reviews and a wide variety of people buying a product more people with be inclined to buy as well. Although you cannot buy an organ if more people were aware of the good in registering to donate more people will want to follow and register as well. It is all about truly trying to be as helpful to the community as possible. I read a book once, Peter Singers, The Most Good You Can Do: How effective altruism is changing ideas about living ethically. This book although not specifically related to organ donation or racial disparity, it holds a concept that I would deem extremely helpful in the world of donation and doing what is best for the people around you without inputting your personal opinion on the topic (Singer, 2016). That is the concept of effective altruism, which I believe can be a helpful solution to racial disparity in regard to organ donation (Singer, 2016). If more people were willing to do what is good, by registering to become a donor, without thought about personal beliefs, I really think more people would become donors. Now of course organ donation is a big concept, one for a lot of people deciding to become one is backed by personal religion, beliefs, and virtues. But if you were to take those backing factors away, and just looked at the good information and statistics that organ donation has, I would hope it would reach more people and be seen as more of an encouragement to register.

But at the end of the day, that is just my opinion and thoughts about different ways to try and end racial disparity in organ donation and transplantation. I am a registered donor, I did it because it is good and right to help out as an individual functioning in society. Yet, I am not everyone, but I am apart of the majority, because I am white. I have never faced racial disparity; I have never not been able to be informed about healthcare and topics that others are not able to get due to race. I am also not in need of an organ transplant, so truthfully this issue does not hit as close to home to me. What does, is that fact that I have the knowledge about this topic from the research I have done. Before writing this paper, I knew the basics, probably what I would say a majority of people know about organ donation. But after doing this research, I found new information that has made me want to encourage more people to be registered to donate. To have more people register from all races and ethnicities will help the whole of the people on the waiting list for a transplant. More people mean a potential for more matches and more people saved. Yes, there are so many outside factors; from mistrust to racism, and religious beliefs that limit people from registering (Bratton, 2011). But if better accessibility to correction information were put out there more individuals would be inclined to register and help others. Organ donation is a choice, but it is one that everyone should try to register and help with, because if more people help, more people become aware which can lead to more individuals wanting to held end the racial disparity seen in the field of organ donation and transplantation.

Bibliography

1. Achieving racial equity in organ transplantation. UNOS. (2020, August 25). https://unos.org/news/racial-equity-in-transplantation/.
2. Bratton, Charles, et al. “Racial Disparities in Organ Donation and Why.” Current Opinion in Organ Transplantation, vol. 16, no. 2, 2011, pp. 243–249., doi:10.1097/mot.0b013e3283447b1c.
3. Horton, R. L., Horton, P. J. (1990). Knowledge regarding organ donation: Identifying and overcoming barriers to organ donation. Social Science